Form Pendaftaran Jamboree

FORM PENDAFTARAN

PESERTA JAMBOREE REMAJA MASJID MUHAMMADIYAH 2014

SE-KOTA YOGYAKARTA

Nama Kelompok                  : ...................................................................................................

Asal Masjid/Musholla          : ...................................................................................................

                                                (Ranting, Cabang)

                                                *Contoh: Masjid Al-Ishlaah, Nitikan, Umbulharjo.

Alamat Lengkap Masjid      : ...................................................................................................

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Kategori Kelompok             : Putra / Putri                                                  

                                              *Coret Salah satu

Ketua Kelompok                  : ...................................................................................................          

Anggota Kelompok             :

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Contact Person Kelompok   : ...................................................................................................

Email dan Website               : ...................................................................................................

                                            

……………………., ……………2014 Nama Ketua Kelompok

*Form ini dapat digandakan sesuai dengan jumlah kelompok yang ikut serta dalam kegiatan JAMBOREE. 

Form (*word) dapat di download disini
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